HomeMy WebLinkAbout914 CHERRY ST - APPLICATIONS - 10/13/2014City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 1P?14OCIQaI Z� APPLICATION DATE
n . , I n i I - 2052.1
Job Site Address Y ' J unit ;F
PROPERTY OWNER INFO: (All owner information is required- it is not optional) Phone #
Last name W I II son First Name ZnrhirL4 Middle Street Add ressq I L-I C h e r (U Si.
PJ ve, rr / City F+, o I( ins State C/
C) zip
CONTRACTOR INFO: Company Name J I t Contractor Phone # l So g ) Zq J - q � I I,
Lic Holder Name
Mailing
LEGAL INFO:
City of Fort Collins License # Supervisor Cert #
City
State
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft -74 0 Comm] Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft
2nd Floor Sq Ft
31 Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths '/< Baths '/z Baths I # of Fireplaces
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
List appropriate option
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ 1 1500
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: `
Electrical O D Mechanical MIA
Framer S2� F' RoofingIv A Concrete
Solar A/ A Other Other
Plumbing M0Q('A,Iq 1 I l.IM61 nQ+
/4 Fireplace /ym
Other
Applicant: I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fort Collins ordinances and state laws regulating building construction.
Lo
��
Applicant Signature 4��/"'IJ� - �� Print Name ��`s�C l t is mhPhon 2, S f Y%4
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE